Provider Demographics
NPI:1548982408
Name:PAGANO, JOSEPH ROBERT (LSW)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:ROBERT
Last Name:PAGANO
Suffix:
Gender:M
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1339 COUNTRY CLUB RD
Mailing Address - Street 2:
Mailing Address - City:MONONGAHELA
Mailing Address - State:PA
Mailing Address - Zip Code:15063-1053
Mailing Address - Country:US
Mailing Address - Phone:724-797-2221
Mailing Address - Fax:
Practice Address - Street 1:35 S WEST ST
Practice Address - Street 2:
Practice Address - City:WAYNESBURG
Practice Address - State:PA
Practice Address - Zip Code:15370-2029
Practice Address - Country:US
Practice Address - Phone:724-627-6108
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-16
Last Update Date:2022-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW139405104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker